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Assessment of the percutaneous dilatational tracheostomy technique in experimental manikins and canine cadavers.

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OBJECTIVE To evaluate procedure time, ease of placement, and complication rates of percutaneous dilatational tracheostomy (PDT) compared to surgical tracheostomy (ST) in canine cadavers. DESIGN Randomized crossover experimental manikin and… Click to show full abstract

OBJECTIVE To evaluate procedure time, ease of placement, and complication rates of percutaneous dilatational tracheostomy (PDT) compared to surgical tracheostomy (ST) in canine cadavers. DESIGN Randomized crossover experimental manikin and cadaver study involving 6 novice veterinary students. SETTING University teaching hospital. ANIMALS Canine tracheostomy training manikin, 24 canine cadavers. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS For training, each student performed 10 PDT and 10 ST procedures on a training manikin, followed by 2 PDT and 2 ST procedures on a canine cadaver. After each training procedure, feedback from bronchoscopy and observers was provided. Final PDT and ST tube placements using new equipment were performed in unused cadavers. Placements were timed, ease of placement was scored using visual analog scales (VAS, 0-10 cm), and complications were assessed by two independent observers using ordinal scales (0-3). Cadaver tracheas were explanted postprocedure to evaluate anatomical damage scores (0-3). Procedure time and VAS scores for PDT and ST procedures were analyzed using mixed-effects linear models, accounting for student, technique, and procedure number with post hoc pairwise comparisons. Data are presented as median (range). For the final cadaver placement, there were no significant differences in placement time (300 seconds [230-1020] vs 188 seconds [116-414], P = 0.210), ease of placement (3.8 cm [2.1-5.7] vs 1.9 cm [0-4.7], P = 0.132), anatomical damage score (1 [0-2] vs 0 [0-1], P = 0.063), or equipment complications score (0 [0-1] vs 0 [0-0], P = 1.000) between PDT and ST, respectively. CONCLUSIONS These data suggest that PDT can be performed as quickly, as easily, and as safely as ST in a canine cadaver by novice veterinary students following manikin training. Additional studies will be required to determine if these findings can be translated into veterinary clinical practice.

Keywords: technique; canine cadavers; percutaneous dilatational; tracheostomy; dilatational tracheostomy; pdt

Journal Title: Journal of veterinary emergency and critical care
Year Published: 2019

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